Latest coronavirus modelling: A north-south divide and a worse over-75 death rate than first estimated

New data shows that 10 per cent of UK population have had virus and 16 to 25-year-olds have highest chance of catching it

A Coronavirus "north-south divide" has emerged across England, according to the latest modelling by scientists at Public Health England (PHE).

The new figures also show that the death rate is far higher for older people than has previously been estimated, and they reveal that nearly one in five children aged between five and 14 has been infected with the disease – the highest of any age group.

The data, calculated by PHE and Cambridge University, suggests that huge numbers of people have already been infected with the virus, around 6.5 million in England overall, including 1.8 million in London.

Around one in five Londoners overall has been infected by the virus since the epidemic began, compared with 14 per cent of people in the north-west, 11 per cent in the Midlands, the north-east and Yorkshire, 10 per cent in the east of England and eight per cent in the south-east.

The lowest region for infections is the south-west, where just five per cent of people are believed to have been infected – although that still amounts to 265,000 cases.

The figures also show that, by the time the UK went into lockdown, the reproduction 'R' rate was already falling in London but remained high in the regions. 

An 'R' rate of one means that every person who has the disease will transmit it to one other person on average. The 'R'’ rate was 2.3 in the capital on March 23, while in the east of England it was three. The north-east and Yorkshire started lockdown with the highest 'R' rate at 3.41, the analysis suggests.

The current 'R' rate for England is 0.75, but in London it is now 0.4 – the lowest in the country – while in the north-east it is 0.8.

Professor Sheila Bird, formerly programme leader at the MRC Biostatistics Unit, University of Cambridge, said: "The aspect which is somewhat surprising is that the initial reproductive number – ie before lockdown – was apparently greater than three outside London in regions to the north.

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"Pre-lockdown, the average number of new infections per infectee was apparently higher in the north and in the east of England than in metropolitan regions, which is thought-provoking about potential reasons."

The north-east and Yorkshire are estimated to have had 935,000 infections so far, with 4,320 people becoming infected on a daily basis, the highest in England at the moment. The rate of decline in the north-east and Yorkshire is also slower, with the number of new infections declining by half in 19 days.

In London, however, there are just 23.9 new cases a day, according to the modelling, and the numbers are halving every 3.5 days – meaning that, unless the 'R' rate rises, the virus could virtually be wiped out in the capital within the next fortnight.

Professor Keith Neal, emeritus professor in the epidemiology of infectious diseases at the University of Nottingham, said that it was possible that areas with low 'R' rates could get the NHS contact tracing app first to trace people who have come into contact with someone who tests positive for coronavirus.

"It is quite likely that some parts of the country have much lower 'R's and fewer cases," he said. "These places could have test, track and trace earlier and restrictions adjusted accordingly."

The data on young people shows that 18 per cent of five to 14-year-olds have had the virus, while 11 per cent of children under five have been infected. Yet very few children have been hospitalised or died from it, suggesting the vast majority had extremely mild symptoms or were completely asymptomatic.

Reception classes, Year One, and Year Six may reopen at the start of June, and although the figures show pupils are in little danger from the virus, they do suggest they could unwittingly transmit it once back mixing in the community.

Some 16 per cent of those aged 15 to 24 have also been infected, the modelling suggests.

In contrast, just six per cent of the over-65s have been infected, and only three per cent of the over-75s, although they are disproportionately more likely to die if they do catch it.

Commenting on the findings, Paul Hunter, professor of medicine at the University of East Anglia, said: "The thing that has surprised me is the high rate in children – 18 per cent. I am not sure I totally believe this but, if true, this is really important and suggests that children are an important vector."

Earlier this week, Osama Rahman, the chief scientific adviser at the Department for Education, admitted there was only a "low degree of confidence" in evidence suggesting that children transmit Covid-19 any less than adults.

Dr Rahman told MPs it was possible that "hundreds of potential vectors" for the virus could be brought together amid a wider reopening of schools.

The Local Government Association is calling for some schools to be given greater local flexibility over reopening because they argue that some communities are at higher risk.

The Government's Covid-19 recovery strategy said the ambition was for all primary school children to return to school before the summer holidays for a month "if feasible". However, experts said it was important to balance the risks and benefits of children going back to the classroom.

Professor Russell Viner, the president of the Royal College of Paediatrics and Child Health, said: "The total numbers of children who get this syndrome are very small. Around 5,000 children die tragically each year. Some of these are premature babies. But 160-170 die in car crashes.

"Those deaths are tragic but also rare. How do we manage those? We take steps to prevent these deaths. We buy child seats, we use seat belts, we sometimes buy better cars. But we don't stop driving.

“We all know that there are many harms for children in lockdown as well. What parents do need, however, is knowledge and understanding so they know what to look out for."

While previous analysis by Imperial College suggested that the overall death rate for those testing positive for coronavirus was 5.1 per cent for people in their 70s and 9.3 per cent for those over 80, the latest analysis puts the death rate for the over-75s at 16 per cent.

But it has dropped the risk of death for younger groups, with nobody under 74 having a risk of death higher than 1.8 per cent – far lower than previously estimated. For people aged 45 to 64, the death rate is now just 0.28 per cent, and for 25 to 44 it is even lower, at 0.018 per cent.

New figures from the Office for National Statistics (ONS) suggest that, from April 27, around 0.27 per cent of the population was infected at any one time – an average of 17,820 people.

However, unlike the PHE and Cambridge figures, the ONS found no difference in the proportions of people testing positive in the different age categories.

Dr Tom Wingfield, senior clinical lecturer and honorary consultant physician at the Liverpool School of Tropical Medicine, said: "Although this data is still preliminary and further work is needed, the suggestion from the ONS survey that children seem similarly likely to have the virus – though not the disease – as adults is particularly important as the Government considers when and how it may lift school closures, although this data can't tell us anything about how likely people of different ages are to transmit the virus."

Experts said it was clear from the analysis that the lockdown had worked. The high number of infected people in London is also likely to slow down, if not totally prevent, a second wave, they believe, although some think it will be impossible to get rid of the virus altogether.

Robert Dingwall, professor of sociology at Nottingham Trent University, said: "SARS-CoV-2 is unlikely to be eradicated from human populations any time soon, if at all. We have to live with this infection, much as we live with seasonal influenza."

Gavin Williamson, the Education Secretary, said he was "more than happy" to share the advice received from the Scientific Advisory Group for Emergencies (Sage) on the reopening of schools.

Speaking to the MPs in the House of Commons on Wednesday, Mr Williamson said: "When you have medical and scientific advice that is saying it's the right time to start bringing schools back in a phased and controlled manner, it seems only the right thing to do and the only responsible thing to do."

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